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Updated: May 5, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Update on newborn screening
1Department of Pediatrics, Levine Children's Hospital, Carolinas HealthCare System, PO Box 32861, Charlotte, NC 28232, USA. susan.sparks@carolinashealthcare.org.
Insights
Newborn screening has grown to cover over 30 conditions since the 1960s. This update covers follow-up, limitations, and ethical considerations of expanded newborn screening programs.
Area of Science:
- Medical Genetics
- Public Health
- Pediatrics
Background:
- Newborn screening began in the 1960s with phenylketonuria (PKU) testing.
- Current newborn screening panels encompass over 30 genetic and metabolic disorders.
- The scope of newborn screening has significantly evolved over the decades.
Purpose of the Study:
- To provide an updated overview of newborn screening practices.
- To discuss the critical aspects of managing abnormal newborn screening results.
- To examine the inherent limitations and ethical dimensions of widespread newborn screening.
Main Methods:
- Literature review of current newborn screening guidelines and practices.
- Analysis of follow-up protocols for infants with positive screening results.
- Discussion of ethical frameworks relevant to genetic screening in newborns.
Main Results:
- Newborn screening now identifies a broad spectrum of conditions beyond PKU.
- Effective follow-up strategies are crucial for positive newborn screening outcomes.
- Screening limitations include false positives/negatives and the identification of conditions with uncertain clinical significance.
Conclusions:
- Expanded newborn screening offers significant public health benefits but requires careful management.
- Addressing the limitations and ethical questions is essential for responsible implementation.
- Ongoing evaluation and adaptation of newborn screening programs are necessary.
Abstract:
Since phenylketonuria was first screened for in the 1960s, newborn screening has expanded to include more than 30 conditions. This commentary provides an update on newborn screening, including the follow-up of abnormal findings, the limitations of such screening, and the ethical questions that screening raises.

